Head of Clinical and Network Operations, Population Health Services Organization
Partner's Healthcare

Job Info

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Site: Mass General Brigham Incorporated

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.

At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.

Job Summary
The Population Health Service Organization (PHSO) at Mass General Brigham aims to deliver healthcare for all by translating the evolving needs of the healthcare landscape into innovative solutions to better serve individuals, communities, and organizations.

In the healthcare industry, we are in a time like no other. Experts estimate that healthcare will evolve more in the next few years than it has in the last 50 years. We have seen governments, employers, and families struggle in the face of rising healthcare costs and a fragmented healthcare system. Patients and communities need more convenient, more affordable, and higher quality care.

We are building a team that can reimagine healthcare and design care models that meet the needs of the people we serve. We are bringing a fresh perspective and a unique approach to create impact for the greater good. By bringing together people from various disciplines and ideas from different industries, we're seeking to address the complex challenges within our healthcare system and leaning forward into a new era of healthcare.

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. At the Mass General Brigham, we place great value on being a diverse and inclusive community. We are dedicated to diversity, equity and inclusion as we aim to reflect the diversity of the patients in our local community. We believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Qualifications

The Population Health Service Organization (PHSO) at Mass General Brigham (MGB) is focused on value-based care, caring for people along the patient journey spanning longitudinal management of chronic conditions and complex care management, transitions or episodes of care, and ongoing prevention and maintenance. We optimize care for Medicare, Medicaid, and commercial populations, included in our value-based risk contracts. In addition, we closely support the MGB Health Plan with medical management and quality measures on jointly managed populations.

The Head of Clinical and Network Operations in the Population Health Service Organization (PHSO) is a senior leader accountable for leading the PHSO clinical, ambulatory quality, and network operations to achieve VBC goals and drive sustained high financial performance across all lines of business. Reporting directly to the Chief Population Health Officer, the role will lead a team of operational and clinical directors, managers, coordinators, etc. who work collaboratively with practices in the network, other PHSO departments, and key leaders across the system by implementing programmatic improvements that bend the total cost of care curve across our populations.

The role is accountable for the performance, effectiveness, and efficiency of the PHSO Clinical and Network Operations:

• Build and lead a high performing VBC clinical operational network
• Champion and codify evidence-based standard protocols and workflows for clinical interventions across the MGB that are innovative and/or align with market best practices
• Provide input on PHSO strategy, initiatives, and department goals and targets
• Develop both operational and outcomes based KPIs that tie PHSO goals and financial performance
• Monitor operational performance relative to benchmarks and targets with a focus on quality, cost, utilization, risk capture accuracy, and patient satisfaction, and risk adjustment.
• Actively engage in quarterly departmental performance reviews, strategic planning sessions and provide operational data and insights to elucidate operational root causes driving quarterly performance trends and take actions to close gaps in performance and prioritize tactics that balance effort and impact.
• Active collaboration, open communications, and partnership with the PHSO Product, Strategy, and Finance functions to solve complex problems.
• Active collaboration with the Office of the CMO, Medical Group, Community Partners, AMC leadership
• Engage with the Product team on the discovery, design, build, and launch of new clinical interventions
• Engage with the Finance team on ensuring clinical operations aligns with financial planning and performance metrics
• Monitor and evaluate the performance and outcomes of the PHSO program using appropriate data sources and analytical tools.
• Effectively lead and communicate performance management initiatives with practice leadership across the MGB network.
• Translate performance data into new clinical workflows as needed to align local operations to best practices and system standards.
• Leverage advanced technical skills in Excel, PowerPoint, Tableau & Epic Reporting to facilitate synthesis and presentation of complex concepts that facilitate PHSO operationalization and coordination with the network and other parts of the system
• Employ advanced financial skills and take a data driven approach by taking financial and clinical data to drive impactful operational performance
• Build business case and/or ROI analysis to evaluate clinical operations efforts' outcomes on financial return.
• Identifying and addressing gaps and opportunities for improvement in the PHSO program and implement corrective actions as needed
• Ongoing review of operations for process improvement and effectiveness

The role will evolve and strengthen the PHSO Clinical and Network Operations teams:

• Lead clinical operations and network teams, with approximately ten direct reports and 100 administrative and clinical staff.
• Strengthen PHSO relationships and structure across the MGB network in collaboration with leaders across the system
• Lead PHSO clinical programs including but not limited to, quality & equity gap services, care management, pharmacy services, etc.
• Oversees PHSO quality program to ensure that the PHSO provides adequate gap closure support to enable MGB clinicians to provide high-quality care for their risk patients.
• Oversee PHSO care management services including but not limited to vended and MGB integrated care management, chronic kidney care, behavioral health services, SDoH services and other care models as they are launched.
• Oversee PHSO central the central pharmacy service including but not limited to care management, quality, ESRD/CKD, transitional care services, hospital/ED readmissions and pharmacy trend management.
• Oversee PHSO post-acute services including transition of care support for patients being discharge from MGB facilities and cared for at partner post-acute facilities.
• Oversees PHSO network function which partners with primary care leadership to embed and adapt PHSO services to local needs and ensure effective use of services to improve performance in risk-based contracts.
• Leading and motivating staff to achieve financial performance and organizational objectives.
• Overseeing the recruitment process to attract the best candidates and reduce employee turnover.
• Mentoring and inspiring employees to key into the vision of MGB and the PHSO.
• Promoting a culture of continuous learning and improvement and support the professional development and growth of PHSO staff and clinicians.

The role will play a critical leadership role on the PHSO team:

• Collaborating with management and other key leaders to carry out business-expanding strategies.
• Partner with Product team to build and scale new clinical services
• Collaborate with Finance team to ensure operations drive achievement of KPIs and provide performance plan actions to close gaps
• Establishing and maintaining effective communication and coordination with internal and external partners, such as providers, clinical staff, system and local administrators, payers, vendors, and community organizations, to foster alignment and collaboration on PHSO goals and initiatives.
• Ensuring compliance with regulatory and accreditation standards, contracts, and policies related to PHSO.

Qualifications:

• A minimum of 10 years of progressive leadership experience, with at least 5 years of senior operational role in a health care setting.
• Demonstrated track record of leading and managing successful healthcare-related programs that resulted in measurable improvements in clinical outcomes, patient experience, and financial performance.
• Deep knowledge of population health concepts, models, and tools, such as risk stratification, care coordination, care transitions, chronic disease management, population health analytics, and value-based payment models.
• Strong analytical, problem-solving, and decision-making skills, with the ability to use data and evidence to inform and guide value-based payment initiatives.
• Master's degree in business administration or equivalent advanced degree preferred.

Additional Job Details (if applicable)

Remote Type

Hybrid

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

EEO Statement:

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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